Treatment for in-hospital heart attacks needs to cool down

Modern medical guidelines suggest a treatment for heart attacks that may seem a bit odd: cooling the patient’s body to a chilly 89.6 degrees.

Normal body temperature is around 98.6 degrees, and an unplanned drop below 95 can have serious downsides. But doctors have discovered that strategically cooling the body can be helpful. A technique called therapeutic hypothermia can be used to dramatically boost survival rates and limit damage when a person’s heart stops.

After a patient’s heartbeat returns, health care providers may use ice packs or special blankets, pads and mattresses to chill the body. Another option is to pump cold fluids into the patient, who is kept sedated. After 24 hours of cooling, the patient is warmed up. The cooling protects the brain from damage that can occur when blood starts flowing again after the heart stops.

The American Heart Association recommends this treatment and studies have shown its effectiveness. But researchers from the University of Pennsylvania say the technique remains underused in hospitals. Their study of six years’ worth of records showed that just 2 percent of patients underwent therapeutic hypothermia after an in-hospital heart attack. Among those who did, nearly half never reached the recommended cooled temperature. Another 17 percent were cooled too much.

People who go into cardiac arrest outside a hospital are more likely to be cooled. Why the discrepancy?

The Pennsylvania researchers say current medical guidelines for heart attacks in hospitals merely suggest cooling as an option. Also, studies of the technique have focused on cardiac arrest that occurs elsewhere. Fixing these two issues may eventually lead to wider use of cooling in hospitals.

And that may mean more heart attack survivors. What could be “cooler” than that?